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Capitol Health Call
June 11, 2008

Health Savings Accounts

JAMA. 2008;299(22):2620. doi:10.1001/jama.299.22.2620-c

Two Democratic House leaders argue that health savings accounts (HSAs) are used more as tax shelters by wealthy people than as a tool for lower-income families to obtain affordable health care coverage.

The accusations were based on a Government Accountability Office report (http://www.gao.gov/new.items/d08474r.pdf) that found the average adjusted gross income of HSA enrollees was about $139 000 compared with $57 000 for those without HSAs. The report also said the total value of all HSA contributions reported to the Internal Revenue Service in 2005 was $754 million while withdrawals totaled $366 million, suggesting the accounts serve more as a tax shelter than a vehicle to make health care more affordable.